SUVmax reduction predicts long-term survival in patients of non-pCR both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma
Abstract Background A pathological complete response (pCR) after neoadjuvant chemoradiotherapy (NACRT) ensures long-term survival in esophageal squamous cell carcinoma (ESCC) patients following esophagectomy, but pCR patients are a minority. The aim here was to identify prognostic factors in patient...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-04-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-021-02208-3 |
| _version_ | 1818966203101609984 |
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| author | Yushi Nagaki Satoru Motoyama Yusuke Sato Akiyuki Wakita Hiromu Fujita Yoshihiro Sasaki Kazuhiro Imai Yoshihiro Minamiya |
| author_facet | Yushi Nagaki Satoru Motoyama Yusuke Sato Akiyuki Wakita Hiromu Fujita Yoshihiro Sasaki Kazuhiro Imai Yoshihiro Minamiya |
| author_sort | Yushi Nagaki |
| collection | DOAJ |
| description | Abstract Background A pathological complete response (pCR) after neoadjuvant chemoradiotherapy (NACRT) ensures long-term survival in esophageal squamous cell carcinoma (ESCC) patients following esophagectomy, but pCR patients are a minority. The aim here was to identify prognostic factors in patients with non-pCR ESCC after NACRT. Methods This is a retrospective study. Investigated were 5-year overall survival (OS), disease-specific survival (DSS), and relapse-free survival (RFS) among non-pCR ESCC patients divided into pT0N0, primary site pCR (pT0N+), lymph node pCR (pT+N0), and non-pCR in both the tumor and lymph node (pT+N+) subgroups after NACRT and esophagectomy. Focusing on the SUVmax reduction rate in the primary tumor in 88 patients who underwent FDG-PET before and after NACRT, we used univariate and multivariate Cox proportional hazard models to identify prognostic factors. Results Although there were no significant survival differences among non-pCR ESCC patients with pT0N+, pT+N0, or pT+N+, survival rate among pT+N+patients was the poorest. After setting a 60% cutoff for the SUVmax reduction rate in the tumor, RFS curves for non-pCR patients significantly differed between patients above the cutoff and those below it. For pT+N+ patients, the SUVmax reduction rate (<60% vs ≥ 60%) was an independent prognostic factor of OS, DSS, and RFS. Conclusion Because ESCC patients with SUVmax reduction rates of <60% in the tumor after NACRT and categorized as pT+N+ after NACRT had significantly poorer prognoses, even after esophagectomy, a change in treatment strategy may be an option to improve survival. |
| first_indexed | 2024-12-20T13:29:10Z |
| format | Article |
| id | doaj.art-b3db0913aaa64709866e69f0b160e1e9 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-20T13:29:10Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-b3db0913aaa64709866e69f0b160e1e92022-12-21T19:39:10ZengBMCWorld Journal of Surgical Oncology1477-78192021-04-0119111110.1186/s12957-021-02208-3SUVmax reduction predicts long-term survival in patients of non-pCR both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinomaYushi Nagaki0Satoru Motoyama1Yusuke Sato2Akiyuki Wakita3Hiromu Fujita4Yoshihiro Sasaki5Kazuhiro Imai6Yoshihiro Minamiya7Division of Esophageal Surgery, Akita University HospitalDivision of Esophageal Surgery, Akita University HospitalDivision of Esophageal Surgery, Akita University HospitalDivision of Esophageal Surgery, Akita University HospitalDivision of Esophageal Surgery, Akita University HospitalDivision of Esophageal Surgery, Akita University HospitalDepartment of Thoracic Surgery, Akita University Graduate School of MedicineDepartment of Thoracic Surgery, Akita University Graduate School of MedicineAbstract Background A pathological complete response (pCR) after neoadjuvant chemoradiotherapy (NACRT) ensures long-term survival in esophageal squamous cell carcinoma (ESCC) patients following esophagectomy, but pCR patients are a minority. The aim here was to identify prognostic factors in patients with non-pCR ESCC after NACRT. Methods This is a retrospective study. Investigated were 5-year overall survival (OS), disease-specific survival (DSS), and relapse-free survival (RFS) among non-pCR ESCC patients divided into pT0N0, primary site pCR (pT0N+), lymph node pCR (pT+N0), and non-pCR in both the tumor and lymph node (pT+N+) subgroups after NACRT and esophagectomy. Focusing on the SUVmax reduction rate in the primary tumor in 88 patients who underwent FDG-PET before and after NACRT, we used univariate and multivariate Cox proportional hazard models to identify prognostic factors. Results Although there were no significant survival differences among non-pCR ESCC patients with pT0N+, pT+N0, or pT+N+, survival rate among pT+N+patients was the poorest. After setting a 60% cutoff for the SUVmax reduction rate in the tumor, RFS curves for non-pCR patients significantly differed between patients above the cutoff and those below it. For pT+N+ patients, the SUVmax reduction rate (<60% vs ≥ 60%) was an independent prognostic factor of OS, DSS, and RFS. Conclusion Because ESCC patients with SUVmax reduction rates of <60% in the tumor after NACRT and categorized as pT+N+ after NACRT had significantly poorer prognoses, even after esophagectomy, a change in treatment strategy may be an option to improve survival.https://doi.org/10.1186/s12957-021-02208-3ESCCNACRTnon-pCRSUVmax |
| spellingShingle | Yushi Nagaki Satoru Motoyama Yusuke Sato Akiyuki Wakita Hiromu Fujita Yoshihiro Sasaki Kazuhiro Imai Yoshihiro Minamiya SUVmax reduction predicts long-term survival in patients of non-pCR both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma World Journal of Surgical Oncology ESCC NACRT non-pCR SUVmax |
| title | SUVmax reduction predicts long-term survival in patients of non-pCR both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma |
| title_full | SUVmax reduction predicts long-term survival in patients of non-pCR both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma |
| title_fullStr | SUVmax reduction predicts long-term survival in patients of non-pCR both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma |
| title_full_unstemmed | SUVmax reduction predicts long-term survival in patients of non-pCR both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma |
| title_short | SUVmax reduction predicts long-term survival in patients of non-pCR both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma |
| title_sort | suvmax reduction predicts long term survival in patients of non pcr both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma |
| topic | ESCC NACRT non-pCR SUVmax |
| url | https://doi.org/10.1186/s12957-021-02208-3 |
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